Observation 1: Inherency Severe lack of funding for the Global Disease Detection program now CDC Professional Judgment FY 2008 4/20/07 __http://www.fundcdc.org/document s/CDCFY2008PJ_000.pdf__ [Ksutt] Surveillance in Africa is crucial to improve health.
Jonathan R. Davisand Joshua Lederberg, Editors Forum on Emerging Infections/Board on Global Health, ’01, The National Academies Press: Emerging Infectious Diseases from the Global to the Local Perspective: Workshop Summary US leadership of surveillance initiatives is the best strategy IOM, March 2003, “Microbial Threats to Health: Emergence, Detection, and Response” __http://www.iom.edu/Object.File /Master/6/146/MicrobialThreat8p gFINAL.pdf____[KSutt__] Funding for CDC towards disease is getting cut at the most crucial moment. Global Health Initiative, ’07, CDC Funding Cuts Compromise U.S. And Global Health, __http://www.familiesusa.org /assets/pdfs/cdc-cuts-compromis e-health.pdf__ Advantage One: Disease First is Emerging diseases Emerging diseases are the greatest threat to human health – monitoring is key.
David L. Heymann, Director, emerging and other communicable diseases surveillance and control – WHO, 5-15-97(Federal News Service, In The News, Before the Senate Committee on Appropriations Subcommittee on Foreign Operations, Lexis) And, Effective disease surveillance is prevented by lack of resources
Stephanie Berger, professor at Columbia University’s Mailman School of Public Health, 6/17/07, “Progress in infectious disease surveillance but gaps remain, says Mailman School of Public Health”, __http://www.eurekalert.org/pub _releases/2007-07/cums-pii07170 7.php__ US Key to solve extinction from pandemics Benatar and Fox 05 – Professor of Medicine and Bioethics @ University of Cape Town and Professor of Sociology and Bioethics @ University of Pennsylvania [Solomon R. Benatar and Renée C. Fox, “Meeting Threats to Global Health: A call for American leadership,” Perspectives in Biology and Medicine 48.3 (2005) 344-361Project Muse] 2. Avian Flu Avian flu is spreading around the world the only way to stop its catastrophic impact is US surveillance in Africa
Declan Butler, “Nature” staff writer , 3/1/”06, “Disease surveillance needs a revolution” http://www.nature.com/nature /journal/v440/n7080/full /440006a.html Surveillance Key to Solve for Avian Flu Outbreak CDC is too weak now TFAH. Trust for America's Health, 4/13/2007, __http://healthvamericans.org /policv/criticalcare/GlobalDete ction.pdf__ [Ksutt]
Sleeping Sickness is rising in prevalence and must be dealt with now CNN, 2/28/98, (“Battling the deadly bite of the tsetse fly”, __http://www.cnn.com/HEALTH/9802 /28/sudan.sleeping.sickness/__ Without increased surveillance Sleeping sickness will spread killing millions CNN, 2/28/98, (“Battling the deadly bite of the tsetse fly”, __http://www.cnn.com/HEALTH/9802 /28/sudan.sleeping.sickness/__ Current efforts and drugs only make the problem worse without surveillance and cooperation the disease will keep spreading
Karen Iley, Reuters staff writer, 2/19/04, (“Sleeping sickness spreading in Angola, MSF says”, __http://www.alertnet.org /thefacts/reliefresources /107720076221.htm__) Sleeping Sickness is one of the most gruesome deaths and if left untreated will kill millions CNN, 2/28/98, (“Battling the deadly bite of the tsetse fly”, __http://www.cnn.com/HEALTH/9802 /28/sudan.sleeping.sickness/__ Advantage Two: Global Health Diplomacy US Aid to Sub-Saharan Africa increases US influence in the region
Peter Brookes is Director of the Asian Studies Center, and Ji Hye Shin Research Assistant in the Asian Studies Center, at The Heritage Foundation, “China's Influence in Africa: Implications for the United States”, Backgrounder #1916, February 22, 2006, __ht____tp://www.heritage.org/Research /AsiaandthePacific/bg1916.cfm__
US and China influence in Africa is zero sum
Jacques DeLisle, Director of FPRI’s Asia Program and Professor of Law @ U. of Penn, February 2007, “Into Africa: China’s Quest for Resource and Influence,”, __http://www.fpri.org/enotes /200702.delisle.intoafricachina squest.html__) If China continues to rise it will go to war with the US
John Mearsheimer, prof of poli sci @ uchicago, Jan/Feb2005, CLASH OF THE TITANS, Foreign Policy, Issue 146, p46 US China war means the end of civilization The Straits Times ’00 (Ching Cheong, June 25, “No one gains in war over Taiwan” ln) Advantage Three: Bioterrorism The world is at a huge risk of bioterrorism (Interpol, Bioterrorism, 18 July 2007, Interpol http://www.interpol.int/Public /BioTerrorism/default.asp) [APATRA] Early response systems best warn against bioterrorism
Valerie Gregg, National Science Foundation Scientist, Spring 2002, Public Health http://www.whsc.emory.edu/ _pubs/ph/spring02/innocence .html [APATRA] Surveillance systems prevent bioterrorism by analyzing data Chang M, Glynn MK, Groseclose SL. Endemic, notifiable bioterrorism-related diseases, United States, 1992-1999. Emerg Infect Dis [serial online] 2003 May http://www.cdc.gov/ncidod/EID /vol9no5/02-0477.htm [APATRA] Bioterrorism the most severe threat to extinction
Thus we offer the following plan: THE UNITED STATES FEDERAL GOVERNMENT SHOULD SUBSTANTIALLY INCREASE ITS PUBLIC HEALTH ASSISTANCE TO SUB-SAHARAN AFRICA BY EXPANDING THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTER FOR DISEASE CONTROL AND PREVENTION’S GLOBAL DISEASE DETECTION PROGRAM TO 3 CENTERS TO BE LOCATED IN THE USAID’S AFRICAN REGION. FUNDING AND ENFORCEMENT GUARANTEED THROUGH NORMAL MEANS. WE RESERVE THE RIGHT TO CLARIFY Observation Three: Solvency A funding increase would strengthen the GDD to a point of useful aid CDC Professional JudgmentFY 2008 4/20/07 **__http://www.fundcdc.org/document s/CDCFY2008PJ_000.pdf__**[Ksutt] Surveillance and prediction through U.S. satellites is integral in developing countries to increase health worker effectiveness NASA, Goddard Space Flight Center “Top Story” News, 2/5/02
“Satellites tracking climate changes and links to disease outbreaks in Africa” **__http://www.gsfc.nasa.gov /topstory/20020204riftvalley .html__**[KSutt] CDC Surveillance is at the forefront of disease prevention and has worked in the past
Stephen Blount M.D., M.P.H., CDC Director of Global Health, 3/3/98
“Testimony on Global Health: the United States Response to Infectious Diseases” __http://www.hhs.gov/asl/testify /t980303a.html__ [Ksutt] Plan key to public health diplomacy Benatar and Fox 05 – Professor of Medicine and Bioethics @ University of Cape Town and Professor of Sociology and Bioethics @ University of Pennsylvania [Solomon R. Benatar and Renée C. Fox, “Meeting Threats to Global Health: A call for American leadership,” Perspectives in Biology and Medicine 48.3 (2005) 344-361Project Muse] The US must lead disease surveillance to ensure national security on bioweapons.
Amy Sands, Ph.D., Deputy Director, Center For Nonproliferation Studies, Monterey Institute Of International Studies, 3-19-02 (‘Reducing The Threat Of Chemical And Biological Weapons”, Hearing Before The Committee On Foreign Relations United States Senate One Hundred Seventh Congress, http://www.globalsecurity.org /military/library/congress /2002_hr/shrg319.pdf, p. 48 [KSutt]
Draft pre practice rounds
1AC Observation 1: Inherency Severe lack of funding for the Global Disease Detection program now CDC Professional Judgment FY 2008 4/20/07 __http://www.fundcdc.org/document s/CDCFY2008PJ_000.pdf__ [KSutt] CDC’s mission-critical health statistics and similar data systems are currently on life support.Investments have simply not kept pace with expenses and technologic advances
that support the ongoing information compass for local, state and national decisions about the health of the population and the operation of the healthcare system. Without adequate funding, CDC will be unable to maintain the current scope and quality of data collection and timeliness of data releases. With enhancements beyond those essential to continuity of existing programs, CDC would provide timely, accurate estimates of high priority health measures including health insurance coverage and monitor the success of CDC Health Protection Goals, including critical information about subgroups at risk for health disparities Surveillance in Africa is crucial to improve health.
Jonathan R. Davisand Joshua Lederberg, Editors Forum on Emerging Infections/Board on Global Health, ’01, The National Academies Press: Emerging Infectious Diseases from the Global to the Local Perspective: Workshop Summary
As a region, Africa is characterized by the greatest infectious disease burden and, overall, the weakest public health infrastructure among all regions in the world. Frequently, vertically oriented disease surveillance programs at the national level and above in Africa often result in too much paperwork, too many different instructions, different terminologies, too many administrators, and conflicting priorities. Streamlined communications, strengthened public health surveillance, the use of standard case definitions, criteria for minimum data requirements, and emphasis on feedback through integrated forms, as well as research and training opportunities, are among the important tools available to improve the situation. Yet, efforts to establish fully more effective public health infrastructures may take a period of years to decades.
US leadership of surveillance initiatives is the best strategy IOM, March 2003, “Microbial Threats to Health: Emergence, Detection, and Response” __http://www.iom.edu/Object.File /Master/6/146/MicrobialThreat8p gFINAL.pdf__[KSutt] The United States should take a leadership role in promoting the implementation of a comprehensive system of surveillance for global infectious diseases that builds on the current global capacity of infectious disease monitoring. To this end, CDC should enhance its regional infectious disease surveillance; DOD should expand and increase in number its Global Emerging Infections Surveillance overseas program sites; and NIH should increase its global surveillance research. In addition, CDC, DOD, and NIH should intensify their efforts to develop and arrange for distribution of laboratory diagnostic reagents needed for global surveillance, transferring technology to other nations where feasible to ensure self-sufficiency and sustainable surveillance capacity.Overseas activities should be coordinated by a single federal agency such as CDC. Sustainable progress and ultimate success in these efforts will require health agencies to broaden partnerships to include nonhealth agencies and institutions such as the World Bank.
Funding for CDC towards disease is getting cut at the most crucial moment. Global Health Initiative, ’07, CDC Funding Cuts Compromise U.S. And Global Health, __http://www.familiesusa.org /assets/pdfs/cdc-cuts-compromis e-health.pdf__
The President’s proposedbudget for fiscal year (FY) 2008once again cuts funding for the core programs of the Centers for Disease Control and Prevention (CDC). This proposal continues a dangerous trend that threatens the CDC’s capacity to prevent and control disease. At a time when public health risks are becoming increasingly complex, a budget proposal that handicaps the world’s foremost public health agency is simply unacceptable. Emerging and re-emerging epidemics such as SARS, tuberculosis (TB), and avian fl u show that infectious diseases do not recognize national borders. The CDC’s global disease surveillance, control, and research expertise are needed now more than ever.
Advantage One: Disease First is Emerging diseases Emerging diseases are the greatest threat to human health – monitoring is key.
David L. Heymann, Director, emerging and other communicable diseases surveillance and control – WHO, 5-15-97 (Federal News Service, In The News, Before the Senate Committee on Appropriations Subcommittee on Foreign Operations, Lexis)
Few public health concerns today carry as much sense of urgency and importance as emerging and re-emerging communicable (infectious) diseases. Many factors contribute to these diseases, including population growth, migration, urbanization and poverty compounded by inadequate or deteriorating public health infrastructures for disease control. Changes in human behavior and alteration in land use, agricultural practices, climate and environmental conditions contribute to increased exposure to and spread of infectious disease agents. Humans, through world travel and trade unprecedented in history, have themselves become a principal vector of infectious diseases, transporting them easily from one country to another within periods less than 24 hours. Fresh concerns have arisen about the ability of infectious agents of animal origin to cross the species barrier from animal to man. Not least, resistance of microorganisms to the drugs used to combat them and resistance of vectors to pesticides used to control them have profound implications for our ability to deal effectively with infectious diseases. Resistance threatens the very base of infectious disease control. Furthermore, infectious diseases can have many sources, from natural human or animal occurrences due to the changing world environment just described to potentially intentional release of pathogens with the objective of harming human health or the health of animals and plants on which humans depend. The urgency and importance for public health of emerging and re- emerging infectious diseases create an urgent need to monitor the situation nationally and globally and to respond in a rapid and effective manner. Effective monitoring and response can only be ensured by international collaboration and the solidarity of many different partners ranging from countries and international organizations to non-governmental organizations, business and industry, government and private public health and laboratory systems, and universities.
And, Effective disease surveillance is prevented by lack of resources
Stephanie Berger, professor at Columbia University’s Mailman School of Public Health, 6/17/07, “Progress in infectious disease surveillance but gaps remain, says Mailman School of Public Health”, http://www.eurekalert.org/pub _releases/2007-07/cums-pii07170 7.php
July 16, 2007 -- The key to control any pandemic is early identification and rapid response. Although considerable progress has been made in global infectious disease surveillance, few scientists are optimistic that an effective early warning system is in place, and many gaps remain, according to researchers at Columbia University’s Mailman School of Public Health. A paper entitled “Global Infectious Disease Surveillance and Health Intelligence,” in the July/August issue of Health Affairs, calls for increasing resources for improved coordination and sharing of information, and additional research to develop the most rigorous triggers for action. Current concerns about the spread of infectious diseases, especially unexpected, emerging infections, have renewed focus on the critical importance of global early warning and rapid response. “The development of effective, interconnected systems of infectious disease surveillance is essential to our survival,” said Stephen S. Morse, PhD, associate professor of clinical Epidemiology in the Department of Epidemiology at the Mailman School, and the paper’s author. “Fortunately, while the increasing availability of communications and information technologies worldwide does offer new opportunities for reporting even in low-capacity settings,resource constraintsremain the missing elements for much of the world.” These information technologies include the Program for Monitoring Emerging Diseases (ProMED), a scientist-to-scientist network connecting more than 30,000 subscribers in 155 countries, and the World Health Organization’s Global Outbreak and Response Network (GOARN).
US Key solve extinction from pandemics Benatar and Fox 05 – Professor of Medicine and Bioethics @ University of Cape Town and Professor of Sociology and Bioethics @ University of Pennsylvania [Solomon R. Benatar and Renée C. Fox, “Meeting Threats to Global Health: A call for American leadership,” Perspectives in Biology and Medicine 48.3 (2005) 344-361Project Muse]
There is a "back to the future" irony in the fact that the eruption and spread of a multitude of "old" and "new" infectious diseases has becomethe most serious global threat to the health of humankind (Benatar 2001a; Garrett 1994). The current epidemics of infectious diseases—including the "white plague" of tuberculosis that was supposed to have yielded to the powers of antibiotics—take their greatest toll on populations of so-called developing countries, and also among disadvantaged groups in privileged "developed" societies (Benatar 2001b; Gandy and Zumla 2003). The recent epidemic of severe acute respiratory syndrome (SARS; Lee et al. 2003) is a small-scale example of the new, acute, rapidly fatal infectious diseases that may, like the 1918–1919 flu epidemic, sweep through the world with high mortality ratesin all countries, with accompanying profound social and economic implications. This paper, by a South African physician and an American medical sociologist, considers challenges that face global health, health care professionals, and governments at the beginning of the 21st century. Our reflections rest on three major premises: that global health problems pose major medical, social, and economic threats to all countries; that it is in the long-term self-interest of wealthy nations to address the forces that significantly affect the health of whole populations; and that at this historical juncture, the United States is the country with the most potential for favorably influencing global health trends. In addition to discussing the nature of threats to global health, we explore some of the major impediments to efforts that could be undertaken to foster alterations in policies that would effectively address the tragic discrepancies in health care and research that currently exist, and to overcome global apathy to the HIV/AIDS pandemic (Hogg et al. 2002). These obstacles involve a confluence of important American values, exemplified by political ideologies that have global as well as national health import; the prevailing ethos of bioethics in the United States; and the current views of many other countries towards the international policies and actions of the United States. As sociologist Robert N. Bellah (2002) has provocatively stated, in and through the "relentless" process of globalization, theUnited States has become a "cultural model and economic dynamo" as well as a military superpower, and more "by default" than by intention, a country with "imperial power." In our view, because of its singularity in these respects (for better or for worse), the United States not only has the scientific, political, and economic capacity to assume major responsibility for improving world health, but also the moral obligation to exemplify and implement values in action that are conducive to this advancement. We make this statement with two caveats. First, we are wary about [End Page 345] unduly promoting the dominance of American influence in the world by encouraging its moral hegemony in global health. Second, as noted above, we are mindful of the cultural and political factors that curtail the readiness and willingness of the United States to assume such a leadership role, and that contribute to health inequities in the American health care system that call for reform rather than emulation. We believe, however, that these caveats should be superseded by the moral imperative of facing up to national and global threats posed by disparities in health and emerging epidemics. Moreover, we believe that the long-term interests of Americans, and indeed of all privileged people and their societies, will be servedby major improvements in global health (Benatar 2003).
2. Avian Flu Avian flu is spreading around the world the only way to stop its catastrophic impact is US surveillance in Africa
Declan Butler, “Nature” staff writer , 3/1/”06, “Disease surveillance needs a revolution” __http://www.nature.com/nature /journal/v440/n7080/full /440006a.html__
With avian flu spreading around the world at a frightening rate, scientists are welcoming an international proposal for state-of-the-art labs to monitor emerging diseases in developing countries. But they add that the bird-flu crisis has exposed glaring deficiencies that demand a radical rethink of the world's veterinary and disease-surveillance systems. Avian flu is now endemic across large parts of Asia, and in the past few weeks has exploded across Europe and into Africa. "H5N1 has focused the spotlight of the world on disease surveillance, and it's showing up all the pimples and warts," says Bill Davenhall, who develops health mapping schemes for countries and is head of health at ESRI, a geographic information systems company in Redlands, California. Developing countries, in particular, lack decent human-disease surveillance, and animal monitoring is often virtually nonexistent, with few basic laboratory and epidemiological resources available. "On the ground in Indonesia, there is no systematic programme at all," says Peter Roeder, a field consultant with the United Nations' Food and Agriculture Organization (FAO). "It's just a bloody mess." Surveillance Key to Solve for Avian Flu Outbreak CDC is too weak now TFAH. Trust for America's Health, 4/13/2007, __http://healthvamericans.org /policv/criticalcare/GlobalDete ction.pdf__ [KSutt]
Currently, the US and the rest of the world are facing a very real threat posed by the highly pathogenic avian influenza. As demonstrated with the SARS outbreak, a highly infectious disease in a remote region of the world can spread in a matter of days and weeks. Investments in infrastructure and human capacity are needed to increase intelligence about global health. Currently, CDC's capacity to identify and respond rapidly to international outbreaks of infectious diseases and to intentional threats is insufficient. Additional disease surveillance tools, laboratory capacity, and CDC expertise deployed abroad can rapidly improve CDC's ability to recognize and intervene in emergent threats—including a possible deadly avian influenza pandemic— before they become significant problems within U.S. borders
Avian flu has potential to kill millions of people and will become the next pandemic if not contained.
Anthony S. Fauci, Nancy A. Touchette, and Gregory K. Folkers, doctors of National Institutes of Health, ’05,
(Emerging Infectious Diseases: a 10-year perspective form the National Institute of Allergy and Infectious Diseases 3/15) __http://www.cdc.gov/ncidod/eid /vol11no04/04-1167.htm__ Each year, influenza develops in up to 20% of all Americans, and >200,000 are hospitalized with the disease. Although influenza is commonplace and generally self-limited, an estimated 36,000 Americans die each year from complications of the disease (__26__). Worldwide, severe influenza infections develop in 3–5 million people annually, and 250,000–500,000 deaths occur (__27__). Outbreaks of avian influenza recently have drawn attention worldwide, particularly in Southeast Asia, where at least 55 persons have been infected and 42 have died since January 2004. The current strain of H5N1 avian influenza is highly pathogenic; it has killed millions of chickens and other birds. Although the virus can cross species to infect humans, few suspected cases of human-to-human transmission have been reported (__27__). However, the virus could acquire characteristics that allow it to be readily transmitted among humans, which could cause a worldwide influenza pandemic, with the potential for killing millions of people. In 1918, a pandemic of the "Spanish Flu" killed 20–50 million people worldwide (__26,27__).
Recently, the NIH Influenza Genomics Project was initiated; it will conduct rapid sequencing of the complete genomes of the several thousand known avian and human influenza viruses as well as those that emerge in the future. Approximately 60 genomes are expected to be sequenced each month. This project should also illuminate the molecular basis of how new strains of influenza virus emerge and provide information on characteristics that contribute to increased virulence. Many researchers believe that the H5N1 virus shows the greatest potential for evolving into the next human pandemic strain. Avian H9N2 viruses also have infected humans and have the potential to cause a pandemic. To prepare for this possibility, the development of vaccines to prevent infection with H5N1 and H9N2 viral strains is being supported (__28__). Researchers also are working to develop a live-attenuated vaccine candidate directed against each of the 15 hemagglutinin proteins that have been isolated, an effort that may speed the development of a vaccine against a potential pandemic strain.
3. Ebola Ebola exists now in Sub-Saharan Africa and will spread African Development Bank, ’02, ( The African Development Bank approves US $500,000 grant for the surveillance of the Ebola type haemorragic fever in Gabon, 10/2) __http://wwwnotes.reliefweb.int /w/rwb.nsf/6686f45896f15dbc8525 67ae00530132/1434fb5f54c18d15c1 256c4e0053f5f4?OpenDocument__ Since 1972, outbreaks of the Ebola type haemorrhagic fever have been identified in the Central African sub-region, namely in the Democratic Republic of Congo, Gabon and Congo. The outbreaks of the epidemic in Gabon occurred respectively in Minkouka in 1994, 1996 in Mayibou II and Makokou in the Ogooué-Ivindo Province, in 1996 and 1997 in the districts of Ovan and Booue in the Province of Ogooué-Ivindo and Koumemeyong. Between October 2001 and May 2002,Gabon experienced its fifth epidemic of the Ebola haemorrhagic fever, which remained confined to two departments (Zadiée and Ivindo) of the Ogooué-Ivindo Province in the country's north-east.
There is a huge threat of a global pandemic only increased resources and surveillance can solve an outbreak CNN, 10/18/95, (“Deadly Ebola virus lurks in the shadows”, __http://www.cnn.com/HEALTH/9510 /emerging_diseases/index.html__ World Health Organization experts say that they have the tools and the skills to fight infectious diseases worldwide, but that's not enough. "What remains to be done is to get an international team of experts on standby which is ready within 24 hours to stop an epidemic should it start anywhere," said Dr. David Heymann of WHO. Such a team would focus on the fundamentals, including how humanity's changing social behavior poses risks. In developing countries, hundreds of thousands of people leave rural areas to seek a better life in major cities. The result is overcrowding and a lack of clean water and sanitation -- a perfect setting for the outbreak of disease.
Ebola is one of the deadliest diseases known to man it is worse than HIV/Aids CNN, 10/18/95, (“Deadly Ebola virus lurks in the shadows”, __http://www.cnn.com/HEALTH/9510 /emerging_diseases/index.html__ Ebola virus victims usually "crash and bleed," a military term which literally means the virus attacks every organ of the body and transforms every part of the body into a digested slime of virus particles. "Ebola does in ten days what it takes HIV ten years to accomplish," wrote Richard Preston in his best-selling non-fiction book "The Hot Zone."
Dr. Lindsay Martinez
Dr. Lindsey Martinez of the World Health Organization said that no one knows where Ebola hides in between epidemics. "And the investigations are still going on, looking at the animal reservoir to try and find which animal or insect may be harboring the virus and allowing it to re-emerge from time to time as happened in Zaire," Martinez said.
4. Sleeping Sickness
Sleeping Sickness is rising in prevalence and must be dealt with now CNN, 2/28/98, (“Battling the deadly bite of the tsetse fly”, __http://www.cnn.com/HEALTH/9802 /28/sudan.sleeping.sickness/__
Dr. Michaleen Richer of the International Medical Corps said the prevalence of sleeping sickness has risen by more than 15 percent.
"This is an epidemic of really catastrophic proportions," Michaleen added. The IMC, U.S. Centers for Disease Control and Prevention, CARE and other organizations are in the midst of a major effort, which began last year, to identify people infected with sleeping sickness and contain the epidemic. But the organizations say their efforts could take years. Meanwhile, WHO estimates that every year some 250,000 to 300,000 men, women and children are left to suffer and die because their illness is going undiagnosed and untreated. And every untreated, undiagnosed human creates a new host for each uninfected tsetse fly, which means the disease spreads exponentially.
Perhaps the saddest commentary on the lives lost is that the illness is relatively easy to treat. But medicine is expensive. It can cost more than $1,000 to cure a sleeping sickness victim.
"Onehundred percent of these people will die if they don't receive medication," said Dr. Sandra Clark of the IMC. "These people have virtually nothing, and they are dependent on the outside world for help."
WHO estimates it costs $27 million a year to fight the disease in the 36 endemic countries, and another $1.5 million a year to coordinate field efforts, technical support and operational research. Some pharmaceutical companies have donated medicine to the cause.
Without increased surveillance Sleeping sickness will spread killing millions CNN, 2/28/98, (“Battling the deadly bite of the tsetse fly”, __http://www.cnn.com/HEALTH/9802 /28/sudan.sleeping.sickness/__
(CNN) -- On the African continent, in the narrow band between the 15th parallels that bookend the equator, a tiny fly is jeopardizing the lives of 55 million people and could be responsible for one of the largest epidemics of this century.
The narrow arc along the equator ventures through 36 sub-Saharan nations, 22 of which are among the most underdeveloped in the world. In every land, the tsetse fly thrives.
Warfare isn't the only force taking a toll on lives in Sudan The tsetse fly feeds on the blood of animals and humans. Its bite can carry a parasite that will work its way through your body and, if left untreated, put you on course for a slow, agonizing and certain death.
It's called the sleeping sickness. The World Health Organization says if the entire at-risk population were put under medical surveillance, the number of diagnosed cases would reach 250,000 to 300,000. But accurate medical surveillance is difficult in a region wracked by civil wars, economic turmoil, environmental changes and displaced populations. WHO estimates that one-tenth of the at-risk population is under surveillance, which has allowed about 25,000 new cases of sleeping sickness to be diagnosed each year. Current efforts and drugs only make the problem worse without surveillance and cooperation the disease will keep spreading
Karen Iley, Reuters staff writer, 2/19/04, (“Sleeping sickness spreading in Angola, MSF says”, __http://www.alertnet.org /thefacts/reliefresources /107720076221.htm__) Both Manuel and Engracia were to be put on drips containing the drug eflornithine (DFMO) to fight the infection coursing through their brains. DFMO, supplied free by French drug giant Aventis,is only slightly less toxic than the main drug used to treat the disease, Melarsoprol (Arsobal), which is based on arsenic and can cause inflammation of the brain. Melarsopal kills around seven percent of patients who use it. Mathela is calling for more research and development to find less toxic, more effective drugs that can treat the disease over the long term.
“Yes, we can treat patients, but more and more people are dying every day because of these old, toxic drugs,” he said. “There is sometimes a resistance to the drugs and the patients have a relapse.
“What we need is good organisation, good collaboration to improve our strategies, make active screenings and improve our coverage. We need to find an alternative drug, and to improve our technique for screening patients so that not so many slip through the net.” MSF said it could not do this alone, and needed the support of public- and private-sector research institutes, governments and the international community to improve screening, control and treatment if the disease’s spread was to be curbed.
Sleeping Sickness is one of the most gruesome deaths and if left untreated will kill millions CNN, 2/28/98, (“Battling the deadly bite of the tsetse fly”, __http://www.cnn.com/HEALTH/9802 /28/sudan.sleeping.sickness/__ Much has been reported about the gruesome deaths associated with hemorrhagic fevers, like Ebola, which can bring a quick death. But imagine having your body slowly destroyed by a parasite that will literally drive you insane. That death is what the bite of the tsetse fly can bring. In the beginning, you may think you have the flu. You can run a high fever, have headaches, joint aches, even itching. As the parasite spreads throughout your bloodstream, it takes its toll on your organs. You can develop anemia or endocrine disorders. You can develop heart and kidney problems. And pregnant women can lose their fetuses. By the time the parasite reaches the central nervous system, you are vulnerable to unpredictable mood changes, and you are so weak that it wears you out to eat or even open your eyes.] You are a danger to yourself and others because you can suffer from sudden bouts of aggressiveness. In some villages, the people tie sleeping-sickness victims to huts or poles to keep them from harming others. Eventually wasted and destroyed, sleeping-sickness victims slip into a deep coma and die.
An old threat Records indicate that Africans have fought against the sleeping sickness as far back as the 14th century. In 1906, an outbreak of sleeping sickness killed 4 million people in Uganda. Health officials say at that time, sleeping sickness was considered the No. 1 public health threat in the tropics.
Advantage Two: Global Health Diplomacy
China and US at odds for Oil control in Africa
William Engdahl, May 20, 2007 __http://www.engdahl.oilgeopoliti cs.net/print/China%20&%20US %20in%20Cold%20War%20over %20Africa's%20Oil.html__ The case of Darfur, a forbidding piece of sun-parched real estate in the southern part of Sudan, illustrates the new Cold War over oil, where the dramatic rise in China’s oil demand to fuel its booming growth has led Beijing to embark on an aggressive policy of – ironically – dollar diplomacy. With its more than $1.3 trillion in mainly US dollar reserves at the People`s Bank of China, Beijing is engaging in active petroleum geopolitics.Africa is a major focus, and in Africa, the central region between Sudan and Chad is priority. This is defining a major new front in what, since the US invasion of Iraq in 2003, is a new Cold War between Washington and Beijing over control of major oil sources. So far Beijing has played its cards a bit more cleverly than Washington. Darfur is a major battleground in this high-stakes contest for oil control. In recent months, Beijing has embarked on a series of initiatives designed to secure long-term raw materials sources from one of the planet’s most endowed regions – the African subcontinent. No raw material has higher priority in Beijing at present than the securing of long term oil sources. Today China draws an estimated 30% of its crude oil from Africa. That explains an extraordinary series of diplomatic initiatives which have left Washington furious. China is using no-strings-attached dollar credits to gain access to Africa’s vast raw material wealth, leaving Washington’s typical control game via the World Bank and IMF out in the cold. Who needs the painful medicine of the IMF when China gives easy terms and builds roads and schools to boot?
US being asked for more involvement and aid to Africa New York Times,Celia W. Dugger, Staff Writer 5/9/07
“Africa: Angola: U.S. Advised To Strengthen Ties To Stabilize Oil Supply __http://query.nytimes.com/gst /fullpage.html?res=9E03E3DA1731 F93AA35756C0A9619C8B63&n=Top %2fReference%2fTimes%20Topics %2fSubjects%2fO%2fOil%20 %28Petroleum%29%20and%20Gasolin e__
A report sponsored by the Council on Foreign Relations, the nongovernmental, nonpartisan organization with headquarters in New York, said the United States should devote significant resources and diplomatic effort to developing ties with Angola, the second largest oil producer in sub-Saharan Africa after Nigeria, and strategically important for ensuring a steady supply of oil and the stability in the oil-rich Gulf of Guinea region. It noted that Angola had one of the world's fastest-growing economies but remained one of the world's least-developed countries. ''Cronyism and the labyrinthine bureaucracy that businesses must navigate to turn a profit frighten away all but the most courageous investors,'' the report said. CELIA W. DUGGER
China and US at zero sum game over resources in Africa
Drew Thompson, Assistant Director of the Freeman Chair in China Studies at the Center for Strategic and International Studies in Washington, DC, June 2005, “China’s Emerging Interests in Africa: Opportunities and Challenges for Africa and the United States” __http://www.hollerafrica.com /showArticle.php?artId=156 &catId=1__ As China’s domestic economy grows, it is expanding and deepening political and economic relations in Africa, primarily to secure access to African markets and raw materials. There is rising concern among some in the United States that China’s growing influence in Africa is a zero-sum equation, whereby China’s rise will ultimately undermine U.S. interests in the region.
If china continues to rise it will go to war with the US
John Mearsheimer, prof of poli sci @ uchicago, Jan/Feb2005, CLASH OF THE TITANS, Foreign Policy, Issue 146, p46 China cannot rise peacefully, and if it continues its dramatic economic growth over the next few decades, the United States and China are likely to engage in an intense security competition with considerable potential for war. Most of China's neighbors, including India, Japan, Singapore, South Korea, Russia, and Vietnam, will likely join with the United States to contain China's power. To predict the future in Asia, one needs a theory that explains how rising powers are likely to act and how other states will react to them. My theory of international politics says that the mightiest states attempt to establish hegemony in their own region while making sure that no rival great power dominates another region.The ultimate goal of every great power is to maximize its share of world power and eventually dominate the system. Contd… From China's point of view, it would be ideal to dominate Asia, and for Brazil, Argentina, or Mexico to became a great power and force the United States to concentrate on its own region. The great advantage the United States has at the moment is that no state in the Western Hemisphere can threaten its survival or security interests. So the United States is free to roam the world causing trouble in other people's backyards. Other states, including China of course, have a vested interest in causing trouble in the United States' backyard to keep it focused there. The picture I have painted is not a pretty one. I wish I could tell a more optimistic story about the future, but international politics is a nasty and dangerous business. No amount of good will can ameliorate the intense security competition that will set in as an aspiring hegemon appears in Asia.
US-China war will cause a nuclear war ending civilization The Straits Times 2K (Ching Cheong, June 25, “No one gains in war over Taiwan” ln)
THE high-intensity scenario postulates a cross-strait war escalating into a full-scale war between the US and China. If Washington were to conclude that splitting China would better serve its national interests, then a full-scale war becomes unavoidable. Conflict on such a scale would embroil other countries far and near and -horror of horrors -raise the possibility of a nuclear war. Beijing has already told the US and Japan privately that it considers any country providing bases and logistics support to any US forces attacking China as belligerent parties open to its retaliation. In the region, this means South Korea, Japan, the Philippines and, to a lesser extent, Singapore. If China were to retaliate, East Asia will be set on fire. Andthe conflagration may not end there as opportunistic powers elsewhere may try to overturn the existing world order. With the US distracted, Russia may seek to redefine Europe's political landscape. The balance of power in the Middle East may be similarly upset by the likes of Iraq. In south Asia, hostilities between India and Pakistan, each armed with its own nuclear arsenal, could enter a new and dangerous phase. Will a full-scale Sino-US war lead to a nuclear war? According to General Matthew Ridgeway, commander of the US Eighth Army, which fought against the Chinese in the Korean War, the US had at the time thought of using nuclear weapons against China to save the US from military defeat. In his book The Korean War, a personal account of the military and political aspects of the conflict and its implications on future US foreign policy, Gen Ridgeway said that US was confronted with two choices in Korea -truce or a broadened war, which could have led to the use of nuclear weapons. If the US had to resort to nuclear weaponry to defeat China long before the latter acquired a similar capability, there is little hope of winning a war against China 50 years later, short of using nuclear weapons. The US estimates that China possesses about 20 nuclear warheads that can destroy major American cities. Beijing also seems prepared to go for the nuclear option. A Chinese military officer disclosed recently that Beijing was considering a review of its "non first use" principle regarding nuclear weapons. Major-General Pan Zhangqiang, president of the military-funded Institute for Strategic Studies, told a gathering at the Woodrow Wilson International Centre for Scholars in Washington that although the government still abided by that principle, there were strong pressures from the military to drop it. He said military leaders considered the use of nuclear weapons mandatory if the country risked dismemberment as a result of foreign intervention. Gen Ridgeway said that should that come to pass, we would see the destruction of civilisation. There would be no victors in such a war. While the prospect of a nuclear Armaggedon over Taiwan might seem inconceivable, it cannot be ruled out entirely, for China puts sovereignty above everything else.
Advantage Three: Bioterrorism The world is at a huge risk of bioterrorism (Interpol, Bioterrorism, 18 July 2007, Interpol http://www.interpol.int/Public /BioTerrorism/default.asp) [APATRA] Why is bioterrorism such a threat?The world is largely unaware of, and therefore largely unprepared for, bioterrorist attacks. Bio-weapons threaten thousands of casualties in addition to other disastrous long term consequences. Criminal networks can covertly transport lethal agents across borders and terrorists have already proven that anthrax can be fatally deployed.
Bio-technology is undergoing rapid evolution. This process, and the wide dissemination of developments, is already proving difficult to manage. There is evidence that terrorist organizations have a heightened interest in the use of biological weapons, establishing terrorist support cells in different regions around the world with the ability and motivation to carry out attacks. An easy option?An effective biological weapon is potentially devastating and much easier to make and transport than a nuclear weapon. Bio-weapons are, however, relatively safe for the terrorist. Pathogens (biological agents or germs) are virtually undetectable and can be brought reasonably easily into a country by an individual and can then be propagated in large quantities. Recognising the imminent dangers represented by this lethal form of crime is the first step in countering the threat. Thereafter it is vital to put in place the tools which will enable society to take appropriate measures. Early response systems best warn against bioterrorism
Valerie Gregg, National Science Foundation Scientist, Spring 2002, Public Health http://www.whsc.emory.edu/ _pubs/ph/spring02/innocence .html [APATRA] Bioterrorism requires a public health system that is strong and well coordinated at every level, Berkelman says. “Early detection by health care providers is our best early–warning system, and education of clinicians is an important defense. In turn, public health officials and health care providers must be tightly linked to assure early recognition and prompt response. Public health agencies and the health care system must, in turn, work seamlessly with other involved agencies, including law enforcement.”
Ensuring the strength of each link in the public health system is essential to controlling epidemics of any infectious disease, including those caused by bioterrorism. “The relationships are vital,” she says. “Surveillance for diseases caused by bioterrorism requires the same system as for other infectious disease. If we can make our public health departments stronger to prepare for bioterrorism, they will be better able to deal with other health threats like influenza, E. coli 0157, and meningococcal disease.”
Surveillance systems prevent bioterrorism by analyzing data Chang M, Glynn MK, Groseclose SL. Endemic, notifiable bioterrorism-related diseases, United States, 1992-1999. Emerg Infect Dis [serial online] 2003 May http://www.cdc.gov/ncidod/EID /vol9no5/02-0477.htm [APATRA]
Using this guidance, public health systems can address the threat of bioterrorism by increasing healthcare sector awareness of and surveillance for these bioterrorism-related agents and the diseases they cause (__10__). In the United States, public health surveillance for conditions caused by the identified critical biologic agents is conducted in multiple ways. Although data regarding these agents are reported to different national surveillance systems at CDC, no single system is specifically designed for conducting surveillance for all bioterrorism-related agents or conditions. However, many states have routinely conducted surveillance for some of these conditions and report incidence data to CDC’s National Notifiable Diseases Surveillance System (NNDSS) each week (__Table 1__). We describe disease-specific trends in demographic characteristics and geographic and seasonal distribution of selected conditions caused by critical biologic agents reported to NNDSS. These diseases and conditions include anthrax, botulism, brucellosis, cholera,plague, tularemia, and selected viral encephalitides. By identifying patterns of endemic disease associated with critical agents, we establish a baseline against which future disease incidence can be compared. This process should allow easier identification of unusual reports of disease incidence, which in turn will enhance the ability of the public health community to identify and investigate outbreaks. Bioterrorism the most severe threat to extinction
Jason Matheny, Department of Agricultural and Resource Economics, University of Maryland, 10/7/06, (“Reducing the risk of human extinction”, http://www.acceleratingfuture .com/papers/extinction.htm) Of current extinction risks, the most severe may be bioterrorism. The knowledge needed to synthesize a virus is modest compared to that needed to build a nuclear weapon; the necessary equipment and materials are increasingly accessible; and because biological agents are self-replicating, a single weapon can have an exponential effect on a population (Warrick, 2006). Current U.S. biodefense efforts are funded at $6 billion per year to develop and stockpile new vaccines and treatments, monitor biological agents and emerging diseases, and strengthen the capacities of local health systems to respond to pandemics.
Thus we offer the following plan: THE UNITED STATES FEDERAL GOVERNMENT SHOULD SUBSTANTIALLY INCREASE ITS PUBLIC HEALTH ASSISTANCE TO SUB-SAHARAN AFRICA BY EXPANDING THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTER FOR DISEASE CONTROL AND PREVENTION’S GLOBAL DISEASE DETECTION PROGRAM TO 3 CENTERS TO BE LOCATED IN SUB-SAHARN AFRICA. FUNDING AND ENFORCEMENT GUARANTEED THROUGH NORMAL MEANS. WE RESERVE THE RIGHT TO CLARIFY
Observation Three: Solvency A funding increase would strengthen the GDD to a point of useful aid CDC Professional Judgment FY 2008 4/20/07 __http://www.fundcdc.org/document s/CDCFY2008PJ_000.pdf__ [KSutt]
CDC is a major partner in our nation’s frontline against emerging international health
threats. CDC’s Global Disease Detection program, in partnership with host country
governments and the WHO, is a key component of this effort and forms the foundation of a transnational detection, prevention and response network to address emerging health threats including pandemic influenza. Withcurrent funding levels, CDC has established 5 regional response Centers, but needs 18– three in each WHO region - to complete thenetwork and properly protect the nation. The existing Centers have already proven their effectiveness muand impact on detecting and responding to outbreaks including avianinfluenza, aflatoxin poisoning, Rift Valley fever, Ebola and Marburg virus outbreaks, andmany other serious infectious diseases and environmental health threats. The Centers also provide a platform for regional training, surveillance, research, and health diplomacyactivities that help promote sustainable health development in the targeted regions.CDC is a major global source of technical and scientific support to categorical disease control programs supported by USG, WHO, health ministries, PEPFAR, the Global Fund, and many other health organizations. Ourinvestment is modest and highly leveraged, but our capacity in most critical areas has been eroded by budget attrition and increases in the costsof science, travel, and infrastructure support in the past few years. We need to continue and expand operational research to assure that investments the USG and others are making in international health are state-of-the science and optimized to achieve results in the field.
Surveillance and prediction through U.S. satellites is integral in developing countries to increase health worker effectiveness NASA, Goddard Space Flight Center “Top Story” News, 2/5/02
“Satellites tracking climate changes and links to disease outbreaks in Africa” __http://www.gsfc.nasa.gov /topstory/20020204riftvalley .html__ [KSutt]
Accurate prediction of epidemics is still years away. But in the short term, satellite monitoring could still benefit public health in developing countries where resources to combat disease are limited. "It is not feasible to send health workers everywhere," Anyamba said. "But if we know where outbreaks are likely, those areas can be targeted. We can focus our efforts where they are needed." Locating those areas requires the use of polar orbiting satellites, such as the Terra satellite, which NASA scientists use to monitor vegetation on the ground. Since green vegetation cover varies with rainfall, it is a good indicator of climate variability, and therefore of conditions necessary for disease outbreaks. "So far, our team has mapped areas of Africa at risk for RVF outbreaks,"Anyamba said. "Satellite mapping has identified where and when RVF outbreaks will occur."
CDC Surveillance is at the forefront of disease prevention and has worked in the past
Stephen Blount M.D., M.P.H., CDC Director of Global Health, 3/3/98
“Testimony on Global Health: the United States Response to Infectious Diseases” __http://www.hhs.gov/asl/testify /t980303a.html__ [KSutt]
I'd also like to mention CDC's work in regard to surveillance and response to a few specific diseases, including influenza -- a disease that has recently been on our minds and in the news. Over the past year, CDC has augmented its international influenza network by increasing the number of surveillance sites in China from 6 to 12, and by training laboratorians from 14 countries in Latin America and the Caribbean. It has also provided resources for enhanced influenza surveillance in Russia. In addition, CDC has worked with the Pan American Health Organization to provide training in the diagnosis of influenza and dengue hemorrhagic fever to support active surveillance for these diseases in the Americas. CDC has played a major role in the development and distribution of reagents through the WHO network for diagnosis and surveillance of the new strain of influenzaidentified in Hong Kong. In conjunction with WHO,CDC has also provided leadership in the development of a protocol for enhanced surveillance for this new strain
Plan key to public health diplomacy Benatar and Fox 05 – Professor of Medicine and Bioethics @ University of Cape Town and Professor of Sociology and Bioethics @ University of Pennsylvania [Solomon R. Benatar and Renée C. Fox, “Meeting Threats to Global Health: A call for American leadership,” Perspectives in Biology and Medicine 48.3 (2005) 344-361Project Muse]
Self-Interest as a Force for Improving Global Health - Just as America has sought widespread solidarity in its campaign against terrorism, so is it now in America's best interests to go beyond merely expressing concern about global health. It should set the example of providing solidarity with [End Page 356] others in their quest for access to the basic requirements for decent and healthyliving that would give hope for their futures. In this sphere, self-interest and a globally responsive and responsible purview coincide. A glimmer that such thinking could increasingly impact on action is evident in the report from the U.S. Council of Foreign Relations and the Milbank Memorial Fund, outlining the importance of health to American foreign policy (Kassalow 2001). American economist Jeffrey Sach's work on the Commission on Macroeconomics for Health, the inauguration of a Global Health Fund, and President Bush's announcement that the United States will increase its annual development aid from $10 billion to $15 billion—while as yet only partially realized promises—are manifestations of both a deeper understanding of the importance of global health and an acknowledgement of the moral responsibility of developed nations to address this constructively (Friedman 2002; Global Fund 2002/3; WHO 2001). For the best American values—embracing both individual freedom and community responsibility—to become globally pervasive and sustainable, it will be necessary for the power of moral example and long-term national interest to complement economic and military power. Unless the world's most powerful country moves towards showing concern for the lives, health, and well-being of the underprivileged, both within its own borders and beyond, it is likely that the lives of the privileged in America and elsewhere will be progressively devalued by those who have little to lose (Nye 2002). The war on Iraq has severely damaged the reputation of the United States as a source of admired values and commitment to human well-being. It has also reduced the potential for the best of American values to be widely emulated (Soros 2004). The challenge of improving health for millions of people provides a window of opportunity to reclaim lost ground for the benefit of Americans and others. The vast gap between the 2004 U.S. military expenditure of $450 billion and official development assistance of only $15 billion illustrates the potential for innovative global health initiatives led by the United States (Sachs 2004). The Role of the American Medical Profession - In our view, it is bothcrucial and obligatory for the American medical profession to play a central rolein the transformation of thought and action that would enable the United States to assume symbolic and substantive leadership in meeting present challenges to global health. As economist Jeffrey Sachs (2004) has stated: "For the first time in decades, we must strive to understand problems—tropical diseases, malnutrition, and the like—[that] are urgent concerns of people abroad. In the case of a superpower ignorance is not bliss; it is a threat to Americans and to humanity." The members of the American medical profession have the trained competence to understand these problems. What is more, as [End Page 357] physicians, they have a collective professional responsibility to be the "conscience of society" in matters that affect and are affected by health and illness. There are those both within and outside the U.S. medical profession who would respond to this exhortation with the claim that at this historical juncture, individually and collectively, American physicians do not have sufficient authority to assume the leadership role being asked of them—that they are too demoralized by the barrage of criticism for excessive dominance and autonomy to which they have been subject from the 1970s through the 1990s, and by their struggles to practice, under the current system of managed care, the kind of medicine that meets their standards of clinical and moral excellence. In response to this contention, we join with medical historian Rosemary Stevens in affirming that there are strong reasons to believe that if the profession mobilizes itself organizationally, its role as moral leaders could be effective:The professionhas long had an authoritative voice in American culture. . . . Despite the doom and gloom expressed over managed care from the early 1990s to the present, doctors have not lost their normative role in American society. They embodya huge reservoir of goodwillinherited from the past. This is derived in various parts: from long respect of the doctor as healer; from the ideology of medicine as public service and the doctor as hero; from the huge advances of scientific medicine in the 20th century, continuing through promises to the future; from claims for scientific objectivity; from the symbolic value of medicine as culturally suited to other American values . . . and . . . from the sheer visibility of national medical organizations, even in the absence of a unified governmental health policy. (Stevens 2001, pp. 348–49)
The US must lead disease surveillance to ensure national security on bioweapons.
Amy Sands, Ph.D., Deputy Director, Center For Nonproliferation Studies, Monterey Institute Of International Studies, 3-19-02 (‘Reducing The Threat Of Chemical And Biological Weapons”, Hearing Before The Committee On Foreign Relations United States Senate One Hundred Seventh Congress, http://www.globalsecurity.org /military/library/congress /2002_hr/shrg319.pdf, p. 48 [KSutt]
To initiate such a process, the United States should work with Europe, Japan and other like-minded states to develop the national legislation needed to prevent misuse and unauthorized access to dangerous biological agents and toxins. Using these efforts as models, the U.S. must lead the effort on an international level and with industry and academia to define international standards of safety and security in the bio-technology sector so that we will have more control over where the materials of concern are, who has access to them, how they are controlled and how they are stored and transferred. A second recommendation is that we strengthen the public health sector within the United States and internationally. We need, obviously it’s been said already today, to improve our own public health sector, but we also need to work with other international groups and foreign governments to the same internationally. The proposed draft legislation of Senator Biden and Helms called the Global Disease Surveillance Act of 2002 reflects the fact that given the speed of international travel, migration patterns and commercial transportation networks, it will not be enough to shore up American public health capabilities and capacities, recognizing that the best BW delivery system might be humans either knowingly or not. Therefore we must assist others to develop capabilities for disease monitoring, surveillance and response or else leave ourselves vulnerable to the possible exposure to dangerous diseases that could be locally contained. Having recognized the need for more support in this area, the challenge, though, will now be to sustain these efforts both in the United States and elsewhere. Since these activities have dual benefits enhancing both national and international security and public health, it is hoped that their value will be clearly evident and funding will become an integral and ongoing element of our national and public security systems
Draft as of Aug 3rd
Observation 1: InherencySevere lack of funding for the Global Disease Detection program now
CDC Professional Judgment FY 2008 4/20/07
__http://www.fundcdc.org/document s/CDCFY2008PJ_000.pdf__ [Ksutt]
Surveillance in Africa is crucial to improve health.
Jonathan R. Davis and Joshua Lederberg, Editors Forum on Emerging Infections/Board on Global Health, ’01, The National Academies Press: Emerging Infectious Diseases from the Global to the Local Perspective: Workshop Summary
US leadership of surveillance initiatives is the best strategy
IOM, March 2003, “Microbial Threats to Health: Emergence, Detection, and Response”
__http://www.iom.edu/Object.File /Master/6/146/MicrobialThreat8p gFINAL.pdf____[KSutt__]
Funding for CDC towards disease is getting cut at the most crucial moment.
Global Health Initiative, ’07, CDC Funding Cuts Compromise U.S. And Global Health, __http://www.familiesusa.org /assets/pdfs/cdc-cuts-compromis e-health.pdf__
Advantage One: Disease
First is Emerging diseases
Emerging diseases are the greatest threat to human health – monitoring is key.
David L. Heymann, Director, emerging and other communicable diseases surveillance and control – WHO, 5-15-97 (Federal News Service, In The News, Before the Senate Committee on Appropriations Subcommittee on Foreign Operations, Lexis)
And, Effective disease surveillance is prevented by lack of resources
Stephanie Berger, professor at Columbia University’s Mailman School of Public Health, 6/17/07, “Progress in infectious disease surveillance but gaps remain, says Mailman School of Public Health”, __http://www.eurekalert.org/pub _releases/2007-07/cums-pii07170 7.php__
US Key to solve extinction from pandemics
Benatar and Fox 05 – Professor of Medicine and Bioethics @ University of Cape Town and Professor of Sociology and Bioethics @ University of Pennsylvania [Solomon R. Benatar and Renée C. Fox, “Meeting Threats to Global Health: A call for American leadership,” Perspectives in Biology and Medicine 48.3 (2005) 344-361Project Muse]
2. Avian Flu
Avian flu is spreading around the world the only way to stop its catastrophic impact is US surveillance in Africa
Declan Butler, “Nature” staff writer , 3/1/”06, “Disease surveillance needs a revolution”
http://www.nature.com/nature /journal/v440/n7080/full /440006a.html
Surveillance Key to Solve for Avian Flu Outbreak CDC is too weak now
TFAH. Trust for America's Health, 4/13/2007,
__http://healthvamericans.org /policv/criticalcare/GlobalDete ction.pdf__ [Ksutt]
Avian flu has potential to kill millions of people and will become the next pandemic if not contained.
Anthony S. Fauci, Nancy A. Touchette, and Gregory K. Folkers, doctors of National Institutes of Health, ’05,
(Emerging Infectious Diseases: a 10-year perspective form the National Institute of Allergy and Infectious Diseases 3/15)
__http://www.cdc.gov/ncidod/eid /vol11no04/04-1167.htm__
3. Ebola
Ebola exists now in Sub-Saharan Africa and will spread
African Development Bank, ’02, ( The African Development Bank approves US $500,000 grant for the surveillance of the Ebola type haemorragic fever in Gabon, 10/2)
__http://wwwnotes.reliefweb.int /w/rwb.nsf/6686f45896f15dbc8525 67ae00530132/1434fb5f54c18d15c1 256c4e0053f5f4?OpenDocument__
There is a huge threat of a global pandemic only increased resources and surveillance can solve an outbreak
CNN, 10/18/95, (“Deadly Ebola virus lurks in the shadows”,
__http://www.cnn.com/HEALTH/9510 /emerging_diseases/index.html__
Ebola is one of the deadliest diseases known to man it is worse than HIV/Aids
CNN, 10/18/95, (“Deadly Ebola virus lurks in the shadows”,
http://www.cnn.com/HEALTH/9510 /emerging_diseases/index.html
4. Sleeping Sickness
Sleeping Sickness is rising in prevalence and must be dealt with now
CNN, 2/28/98, (“Battling the deadly bite of the tsetse fly”,
__http://www.cnn.com/HEALTH/9802 /28/sudan.sleeping.sickness/__
Without increased surveillance Sleeping sickness will spread killing millions
CNN, 2/28/98, (“Battling the deadly bite of the tsetse fly”,
__http://www.cnn.com/HEALTH/9802 /28/sudan.sleeping.sickness/__
Current efforts and drugs only make the problem worse without surveillance and cooperation the disease will keep spreading
Karen Iley, Reuters staff writer, 2/19/04, (“Sleeping sickness spreading in Angola, MSF says”,
__http://www.alertnet.org /thefacts/reliefresources /107720076221.htm__)
Sleeping Sickness is one of the most gruesome deaths and if left untreated will kill millions
CNN, 2/28/98, (“Battling the deadly bite of the tsetse fly”,
__http://www.cnn.com/HEALTH/9802 /28/sudan.sleeping.sickness/__
Advantage Two: Global Health Diplomacy
US Aid to Sub-Saharan Africa increases US influence in the region
Peter Brookes is Director of the Asian Studies Center, and Ji Hye Shin Research Assistant in the Asian Studies Center, at The Heritage Foundation, “China's Influence in Africa: Implications for the United States”, Backgrounder #1916, February 22, 2006,
__ht____tp://www.heritage.org/Research /AsiaandthePacific/bg1916.cfm__
US and China influence in Africa is zero sum
Jacques DeLisle, Director of FPRI’s Asia Program and Professor of Law @ U. of Penn, February 2007, “Into Africa: China’s Quest for Resource and Influence,”, __http://www.fpri.org/enotes /200702.delisle.intoafricachina squest.html__)
If China continues to rise it will go to war with the US
John Mearsheimer, prof of poli sci @ uchicago, Jan/Feb2005, CLASH OF THE TITANS, Foreign Policy, Issue 146, p46
US China war means the end of civilization
The Straits Times ’00 (Ching Cheong, June 25, “No one gains in war over Taiwan” ln)
Advantage Three: Bioterrorism
The world is at a huge risk of bioterrorism
(Interpol, Bioterrorism, 18 July 2007, Interpol
http://www.interpol.int/Public /BioTerrorism/default.asp) [APATRA]
Early response systems best warn against bioterrorism
Valerie Gregg, National Science Foundation Scientist, Spring 2002, Public Health http://www.whsc.emory.edu/ _pubs/ph/spring02/innocence .html [APATRA]
Surveillance systems prevent bioterrorism by analyzing data
Chang M, Glynn MK, Groseclose SL. Endemic, notifiable bioterrorism-related diseases, United States, 1992-1999. Emerg Infect Dis [serial online] 2003 May http://www.cdc.gov/ncidod/EID /vol9no5/02-0477.htm [APATRA]
Bioterrorism the most severe threat to extinction
Jason Matheny, Department of Agricultural and Resource Economics, University of Maryland, 10/7/06, (“Reducing the risk of human extinction”, __http://www.acceleratingfuture .com/papers/extinction.htm__)
Thus we offer the following plan:
THE UNITED STATES FEDERAL GOVERNMENT SHOULD SUBSTANTIALLY INCREASE ITS PUBLIC HEALTH ASSISTANCE TO SUB-SAHARAN AFRICA BY EXPANDING THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTER FOR DISEASE CONTROL AND PREVENTION’S GLOBAL DISEASE DETECTION PROGRAM TO 3 CENTERS TO BE LOCATED IN THE USAID’S AFRICAN REGION.
FUNDING AND ENFORCEMENT GUARANTEED THROUGH NORMAL MEANS.
WE RESERVE THE RIGHT TO CLARIFY
Observation Three: Solvency
A funding increase would strengthen the GDD to a point of useful aid
CDC Professional Judgment FY 2008 4/20/07
**__http://www.fundcdc.org/document s/CDCFY2008PJ_000.pdf__** [Ksutt]
Surveillance and prediction through U.S. satellites is integral in developing countries to increase health worker effectiveness
NASA, Goddard Space Flight Center “Top Story” News, 2/5/02
“Satellites tracking climate changes and links to disease outbreaks in Africa”
**__http://www.gsfc.nasa.gov /topstory/20020204riftvalley .html__** [KSutt]
CDC Surveillance is at the forefront of disease prevention and has worked in the past
Stephen Blount M.D., M.P.H., CDC Director of Global Health, 3/3/98
“Testimony on Global Health: the United States Response to Infectious Diseases”
__http://www.hhs.gov/asl/testify /t980303a.html__ [Ksutt]
Plan key to public health diplomacy
Benatar and Fox 05 – Professor of Medicine and Bioethics @ University of Cape Town and Professor of Sociology and Bioethics @ University of Pennsylvania [Solomon R. Benatar and Renée C. Fox, “Meeting Threats to Global Health: A call for American leadership,” Perspectives in Biology and Medicine 48.3 (2005) 344-361Project Muse]
The US must lead disease surveillance to ensure national security on bioweapons.
Amy Sands, Ph.D., Deputy Director, Center For Nonproliferation Studies, Monterey Institute Of International Studies, 3-19-02 (‘Reducing The Threat Of Chemical And Biological Weapons”, Hearing Before The Committee On Foreign Relations United States Senate One Hundred Seventh Congress, http://www.globalsecurity.org /military/library/congress /2002_hr/shrg319.pdf, p. 48 [KSutt]
Draft pre practice rounds
1AC
Observation 1: Inherency
Severe lack of funding for the Global Disease Detection program now
CDC Professional Judgment FY 2008 4/20/07
__http://www.fundcdc.org/document s/CDCFY2008PJ_000.pdf__ [KSutt]
CDC’s mission-critical health statistics and similar data systems are currently on life
support. Investments have simply not kept pace with expenses and technologic advances
that support the ongoing information compass for local, state and national decisions about the health of the population and the operation of the healthcare system. Without adequate funding, CDC will be unable to maintain the current scope and quality of data collection and timeliness of data releases. With enhancements beyond those essential to continuity of existing programs, CDC would provide timely, accurate estimates of high priority health measures including health insurance coverage and monitor the success of CDC Health Protection Goals, including critical information about subgroups at risk for health disparities
Surveillance in Africa is crucial to improve health.
Jonathan R. Davis and Joshua Lederberg, Editors Forum on Emerging Infections/Board on Global Health, ’01, The National Academies Press: Emerging Infectious Diseases from the Global to the Local Perspective: Workshop Summary
As a region, Africa is characterized by the greatest infectious disease burden and, overall, the weakest public health infrastructure among all regions in the world. Frequently, vertically oriented disease surveillance programs at the national level and above in Africa often result in too much paperwork, too many different instructions, different terminologies, too many administrators, and conflicting priorities. Streamlined communications, strengthened public health surveillance, the use of standard case definitions, criteria for minimum data requirements, and emphasis on feedback through integrated forms, as well as research and training opportunities, are among the important tools available to improve the situation. Yet, efforts to establish fully more effective public health infrastructures may take a period of years to decades.
US leadership of surveillance initiatives is the best strategy
IOM, March 2003, “Microbial Threats to Health: Emergence, Detection, and Response”
__http://www.iom.edu/Object.File /Master/6/146/MicrobialThreat8p gFINAL.pdf__[KSutt]
The United States should take a leadership role in promoting the implementation of a comprehensive system of surveillance for global infectious diseases that builds on the current global capacity of infectious disease monitoring. To this end, CDC should enhance its regional infectious disease surveillance; DOD should expand and increase in number its Global Emerging Infections Surveillance overseas program sites; and NIH should increase its global surveillance research. In addition, CDC, DOD, and NIH should intensify their efforts to develop and arrange for distribution of laboratory diagnostic reagents needed for global surveillance, transferring technology to other nations where feasible to ensure self-sufficiency and sustainable surveillance capacity. Overseas activities should be coordinated by a single federal agency such as CDC. Sustainable progress and ultimate success in these efforts will require health agencies to broaden partnerships to include nonhealth agencies and institutions such as the World Bank.
Funding for CDC towards disease is getting cut at the most crucial moment.
Global Health Initiative, ’07, CDC Funding Cuts Compromise U.S. And Global Health, __http://www.familiesusa.org /assets/pdfs/cdc-cuts-compromis e-health.pdf__
The President’s proposed budget for fiscal year (FY) 2008 once again cuts funding for the core programs of the Centers for Disease Control and Prevention (CDC). This proposal continues a dangerous trend that threatens the CDC’s capacity to prevent and control disease. At a time when public health risks are becoming increasingly complex, a budget proposal that handicaps the world’s foremost public health agency is simply unacceptable. Emerging and re-emerging epidemics such as SARS, tuberculosis (TB), and avian fl u show that infectious diseases do not recognize national borders. The CDC’s global disease surveillance, control, and research expertise are needed now more than ever.
Advantage One: Disease
First is Emerging diseases
Emerging diseases are the greatest threat to human health – monitoring is key.
David L. Heymann, Director, emerging and other communicable diseases surveillance and control – WHO, 5-15-97 (Federal News Service, In The News, Before the Senate Committee on Appropriations Subcommittee on Foreign Operations, Lexis)
Few public health concerns today carry as much sense of urgency and importance as emerging and re-emerging communicable (infectious) diseases. Many factors contribute to these diseases, including population growth, migration, urbanization and poverty compounded by inadequate or deteriorating public health infrastructures for disease control. Changes in human behavior and alteration in land use, agricultural practices, climate and environmental conditions contribute to increased exposure to and spread of infectious disease agents. Humans, through world travel and trade unprecedented in history, have themselves become a principal vector of infectious diseases, transporting them easily from one country to another within periods less than 24 hours. Fresh concerns have arisen about the ability of infectious agents of animal origin to cross the species barrier from animal to man. Not least, resistance of microorganisms to the drugs used to combat them and resistance of vectors to pesticides used to control them have profound implications for our ability to deal effectively with infectious diseases. Resistance threatens the very base of infectious disease control. Furthermore, infectious diseases can have many sources, from natural human or animal occurrences due to the changing world environment just described to potentially intentional release of pathogens with the objective of harming human health or the health of animals and plants on which humans depend. The urgency and importance for public health of emerging and re- emerging infectious diseases create an urgent need to monitor the situation nationally and globally and to respond in a rapid and effective manner. Effective monitoring and response can only be ensured by international collaboration and the solidarity of many different partners ranging from countries and international organizations to non-governmental organizations, business and industry, government and private public health and laboratory systems, and universities.
And, Effective disease surveillance is prevented by lack of resources
Stephanie Berger, professor at Columbia University’s Mailman School of Public Health, 6/17/07, “Progress in infectious disease surveillance but gaps remain, says Mailman School of Public Health”, http://www.eurekalert.org/pub _releases/2007-07/cums-pii07170 7.php
July 16, 2007 -- The key to control any pandemic is early identification and rapid response. Although considerable progress has been made in global infectious disease surveillance, few scientists are optimistic that an effective early warning system is in place, and many gaps remain, according to researchers at Columbia University’s Mailman School of Public Health. A paper entitled “Global Infectious Disease Surveillance and Health Intelligence,” in the July/August issue of Health Affairs, calls for increasing resources for improved coordination and sharing of information, and additional research to develop the most rigorous triggers for action.
Current concerns about the spread of infectious diseases, especially unexpected, emerging infections, have renewed focus on the critical importance of global early warning and rapid response. “The development of effective, interconnected systems of infectious disease surveillance is essential to our survival,” said Stephen S. Morse, PhD, associate professor of clinical Epidemiology in the Department of Epidemiology at the Mailman School, and the paper’s author. “Fortunately, while the increasing availability of communications and information technologies worldwide does offer new opportunities for reporting even in low-capacity settings, resource constraints remain the missing elements for much of the world.” These information technologies include the Program for Monitoring Emerging Diseases (ProMED), a scientist-to-scientist network connecting more than 30,000 subscribers in 155 countries, and the World Health Organization’s Global Outbreak and Response Network (GOARN).
US Key solve extinction from pandemics
Benatar and Fox 05 – Professor of Medicine and Bioethics @ University of Cape Town and Professor of Sociology and Bioethics @ University of Pennsylvania [Solomon R. Benatar and Renée C. Fox, “Meeting Threats to Global Health: A call for American leadership,” Perspectives in Biology and Medicine 48.3 (2005) 344-361Project Muse]
There is a "back to the future" irony in the fact that the eruption and spread of a multitude of "old" and "new" infectious diseases has become the most serious global threat to the health of humankind (Benatar 2001a; Garrett 1994). The current epidemics of infectious diseases—including the "white plague" of tuberculosis that was supposed to have yielded to the powers of antibiotics—take their greatest toll on populations of so-called developing countries, and also among disadvantaged groups in privileged "developed" societies (Benatar 2001b; Gandy and Zumla 2003). The recent epidemic of severe acute respiratory syndrome (SARS; Lee et al. 2003) is a small-scale example of the new, acute, rapidly fatal infectious diseases that may, like the 1918–1919 flu epidemic, sweep through the world with high mortality rates in all countries, with accompanying profound social and economic implications. This paper, by a South African physician and an American medical sociologist, considers challenges that face global health, health care professionals, and governments at the beginning of the 21st century. Our reflections rest on three major premises: that global health problems pose major medical, social, and economic threats to all countries; that it is in the long-term self-interest of wealthy nations to address the forces that significantly affect the health of whole populations; and that at this historical juncture, the United States is the country with the most potential for favorably influencing global health trends. In addition to discussing the nature of threats to global health, we explore some of the major impediments to efforts that could be undertaken to foster alterations in policies that would effectively address the tragic discrepancies in health care and research that currently exist, and to overcome global apathy to the HIV/AIDS pandemic (Hogg et al. 2002). These obstacles involve a confluence of important American values, exemplified by political ideologies that have global as well as national health import; the prevailing ethos of bioethics in the United States; and the current views of many other countries towards the international policies and actions of the United States. As sociologist Robert N. Bellah (2002) has provocatively stated, in and through the "relentless" process of globalization, the United States has become a "cultural model and economic dynamo" as well as a military superpower, and more "by default" than by intention, a country with "imperial power." In our view, because of its singularity in these respects (for better or for worse), the United States not only has the scientific, political, and economic capacity to assume major responsibility for improving world health, but also the moral obligation to exemplify and implement values in action that are conducive to this advancement. We make this statement with two caveats. First, we are wary about [End Page 345] unduly promoting the dominance of American influence in the world by encouraging its moral hegemony in global health. Second, as noted above, we are mindful of the cultural and political factors that curtail the readiness and willingness of the United States to assume such a leadership role, and that contribute to health inequities in the American health care system that call for reform rather than emulation. We believe, however, that these caveats should be superseded by the moral imperative of facing up to national and global threats posed by disparities in health and emerging epidemics. Moreover, we believe that the long-term interests of Americans, and indeed of all privileged people and their societies, will be served by major improvements in global health (Benatar 2003).
2. Avian Flu
Avian flu is spreading around the world the only way to stop its catastrophic impact is US surveillance in Africa
Declan Butler, “Nature” staff writer , 3/1/”06, “Disease surveillance needs a revolution” __http://www.nature.com/nature /journal/v440/n7080/full /440006a.html__
With avian flu spreading around the world at a frightening rate, scientists are welcoming an international proposal for state-of-the-art labs to monitor emerging diseases in developing countries. But they add that the bird-flu crisis has exposed glaring deficiencies that demand a radical rethink of the world's veterinary and disease-surveillance systems.
Avian flu is now endemic across large parts of Asia, and in the past few weeks has exploded across Europe and into Africa. "H5N1 has focused the spotlight of the world on disease surveillance, and it's showing up all the pimples and warts," says Bill Davenhall, who develops health mapping schemes for countries and is head of health at ESRI, a geographic information systems company in Redlands, California.
Developing countries, in particular, lack decent human-disease surveillance, and animal monitoring is often virtually nonexistent, with few basic laboratory and epidemiological resources available. "On the ground in Indonesia, there is no systematic programme at all," says Peter Roeder, a field consultant with the United Nations' Food and Agriculture Organization (FAO). "It's just a bloody mess."
Surveillance Key to Solve for Avian Flu Outbreak CDC is too weak now
TFAH. Trust for America's Health, 4/13/2007, __http://healthvamericans.org /policv/criticalcare/GlobalDete ction.pdf__ [KSutt]
Currently, the US and the rest of the world are facing a very real threat posed by the highly pathogenic avian influenza. As demonstrated with the SARS outbreak, a highly infectious disease in a remote region of the world can spread in a matter of days and weeks. Investments in infrastructure and human capacity are needed to increase intelligence about global health. Currently, CDC's capacity to identify and respond rapidly to international outbreaks of infectious diseases and to intentional threats is insufficient. Additional disease surveillance tools, laboratory capacity, and CDC expertise deployed abroad can rapidly improve CDC's ability to recognize and intervene in emergent threats—including a possible deadly avian influenza pandemic— before they become significant problems within U.S. borders
Avian flu has potential to kill millions of people and will become the next pandemic if not contained.
Anthony S. Fauci, Nancy A. Touchette, and Gregory K. Folkers, doctors of National Institutes of Health, ’05,
(Emerging Infectious Diseases: a 10-year perspective form the National Institute of Allergy and Infectious Diseases 3/15) __http://www.cdc.gov/ncidod/eid /vol11no04/04-1167.htm__
Each year, influenza develops in up to 20% of all Americans, and >200,000 are hospitalized with the disease. Although influenza is commonplace and generally self-limited, an estimated 36,000 Americans die each year from complications of the disease (__26__). Worldwide, severe influenza infections develop in 3–5 million people annually, and 250,000–500,000 deaths occur (__27__).
Outbreaks of avian influenza recently have drawn attention worldwide, particularly in Southeast Asia, where at least 55 persons have been infected and 42 have died since January 2004. The current strain of H5N1 avian influenza is highly pathogenic; it has killed millions of chickens and other birds. Although the virus can cross species to infect humans, few suspected cases of human-to-human transmission have been reported (__27__). However, the virus could acquire characteristics that allow it to be readily transmitted among humans, which could cause a worldwide influenza pandemic, with the potential for killing millions of people. In 1918, a pandemic of the "Spanish Flu" killed 20–50 million people worldwide (__26,27__).
Recently, the NIH Influenza Genomics Project was initiated; it will conduct rapid sequencing of the complete genomes of the several thousand known avian and human influenza viruses as well as those that emerge in the future. Approximately 60 genomes are expected to be sequenced each month. This project should also illuminate the molecular basis of how new strains of influenza virus emerge and provide information on characteristics that contribute to increased virulence. Many researchers believe that the H5N1 virus shows the greatest potential for evolving into the next human pandemic strain. Avian H9N2 viruses also have infected humans and have the potential to cause a pandemic. To prepare for this possibility, the development of vaccines to prevent infection with H5N1 and H9N2 viral strains is being supported (__28__). Researchers also are working to develop a live-attenuated vaccine candidate directed against each of the 15 hemagglutinin proteins that have been isolated, an effort that may speed the development of a vaccine against a potential pandemic strain.
3. Ebola
Ebola exists now in Sub-Saharan Africa and will spread
African Development Bank, ’02, ( The African Development Bank approves US $500,000 grant for the surveillance of the Ebola type haemorragic fever in Gabon, 10/2) __http://wwwnotes.reliefweb.int /w/rwb.nsf/6686f45896f15dbc8525 67ae00530132/1434fb5f54c18d15c1 256c4e0053f5f4?OpenDocument__
Since 1972, outbreaks of the Ebola type haemorrhagic fever have been identified in the Central African sub-region, namely in the Democratic Republic of Congo, Gabon and Congo. The outbreaks of the epidemic in Gabon occurred respectively in Minkouka in 1994, 1996 in Mayibou II and Makokou in the Ogooué-Ivindo Province, in 1996 and 1997 in the districts of Ovan and Booue in the Province of Ogooué-Ivindo and Koumemeyong. Between October 2001 and May 2002, Gabon experienced its fifth epidemic of the Ebola haemorrhagic fever, which remained confined to two departments (Zadiée and Ivindo) of the Ogooué-Ivindo Province in the country's north-east.
There is a huge threat of a global pandemic only increased resources and surveillance can solve an outbreak
CNN, 10/18/95, (“Deadly Ebola virus lurks in the shadows”, __http://www.cnn.com/HEALTH/9510 /emerging_diseases/index.html__
World Health Organization experts say that they have the tools and the skills to fight infectious diseases worldwide, but that's not enough. "What remains to be done is to get an international team of experts on standby which is ready within 24 hours to stop an epidemic should it start anywhere," said Dr. David Heymann of WHO.
Such a team would focus on the fundamentals, including how humanity's changing social behavior poses risks. In developing countries, hundreds of thousands of people leave rural areas to seek a better life in major cities. The result is overcrowding and a lack of clean water and sanitation -- a perfect setting for the outbreak of disease.
Ebola is one of the deadliest diseases known to man it is worse than HIV/Aids
CNN, 10/18/95, (“Deadly Ebola virus lurks in the shadows”, __http://www.cnn.com/HEALTH/9510 /emerging_diseases/index.html__
Ebola virus victims usually "crash and bleed," a military term which literally means the virus attacks every organ of the body and transforms every part of the body into a digested slime of virus particles. "Ebola does in ten days what it takes HIV ten years to accomplish," wrote Richard Preston in his best-selling non-fiction book "The Hot Zone."
Dr. Lindsay Martinez
Dr. Lindsey Martinez of the World Health Organization said that no one knows where Ebola hides in between epidemics. "And the investigations are still going on, looking at the animal reservoir to try and find which animal or insect may be harboring the virus and allowing it to re-emerge from time to time as happened in Zaire," Martinez said.
4. Sleeping Sickness
Sleeping Sickness is rising in prevalence and must be dealt with now
CNN, 2/28/98, (“Battling the deadly bite of the tsetse fly”, __http://www.cnn.com/HEALTH/9802 /28/sudan.sleeping.sickness/__
Dr. Michaleen Richer of the International Medical Corps said the prevalence of sleeping sickness has risen by more than 15 percent.
"This is an epidemic of really catastrophic proportions," Michaleen added.
The IMC, U.S. Centers for Disease Control and Prevention, CARE and other organizations are in the midst of a major effort, which began last year, to identify people infected with sleeping sickness and contain the epidemic.
But the organizations say their efforts could take years. Meanwhile, WHO estimates that every year some 250,000 to 300,000 men, women and children are left to suffer and die because their illness is going undiagnosed and untreated.
And every untreated, undiagnosed human creates a new host for each uninfected tsetse fly, which means the disease spreads exponentially.
Perhaps the saddest commentary on the lives lost is that the illness is relatively easy to treat. But medicine is expensive. It can cost more than $1,000 to cure a sleeping sickness victim.
"One hundred percent of these people will die if they don't receive medication," said Dr. Sandra Clark of the IMC. "These people have virtually nothing, and they are dependent on the outside world for help."
WHO estimates it costs $27 million a year to fight the disease in the 36 endemic countries, and another $1.5 million a year to coordinate field efforts, technical support and operational research.
Some pharmaceutical companies have donated medicine to the cause.
Without increased surveillance Sleeping sickness will spread killing millions
CNN, 2/28/98, (“Battling the deadly bite of the tsetse fly”, __http://www.cnn.com/HEALTH/9802 /28/sudan.sleeping.sickness/__
(CNN) -- On the African continent, in the narrow band between the 15th parallels that bookend the equator, a tiny fly is jeopardizing the lives of 55 million people and could be responsible for one of the largest epidemics of this century.
The narrow arc along the equator ventures through 36 sub-Saharan nations, 22 of which are among the most underdeveloped in the world. In every land, the tsetse fly thrives.
Warfare isn't the only force taking a toll on lives in Sudan
The tsetse fly feeds on the blood of animals and humans. Its bite can carry a parasite that will work its way through your body and, if left untreated, put you on course for a slow, agonizing and certain death.
It's called the sleeping sickness.
The World Health Organization says if the entire at-risk population were put under medical surveillance, the number of diagnosed cases would reach 250,000 to 300,000.
But accurate medical surveillance is difficult in a region wracked by civil wars, economic turmoil, environmental changes and displaced populations. WHO estimates that one-tenth of the at-risk population is under surveillance, which has allowed about 25,000 new cases of sleeping sickness to be diagnosed each year.
Current efforts and drugs only make the problem worse without surveillance and cooperation the disease will keep spreading
Karen Iley, Reuters staff writer, 2/19/04, (“Sleeping sickness spreading in Angola, MSF says”, __http://www.alertnet.org /thefacts/reliefresources /107720076221.htm__)
Both Manuel and Engracia were to be put on drips containing the drug eflornithine (DFMO) to fight the infection coursing through their brains.
DFMO, supplied free by French drug giant Aventis, is only slightly less toxic than the main drug used to treat the disease, Melarsoprol (Arsobal), which is based on arsenic and can cause inflammation of the brain.
Melarsopal kills around seven percent of patients who use it.
Mathela is calling for more research and development to find less toxic, more effective drugs that can treat the disease over the long term.
“Yes, we can treat patients, but more and more people are dying every day because of these old, toxic drugs,” he said. “There is sometimes a resistance to the drugs and the patients have a relapse.
“What we need is good organisation, good collaboration to improve our strategies, make active screenings and improve our coverage. We need to find an alternative drug, and to improve our technique for screening patients so that not so many slip through the net.”
MSF said it could not do this alone, and needed the support of public- and private-sector research institutes, governments and the international community to improve screening, control and treatment if the disease’s spread was to be curbed.
Sleeping Sickness is one of the most gruesome deaths and if left untreated will kill millions
CNN, 2/28/98, (“Battling the deadly bite of the tsetse fly”, __http://www.cnn.com/HEALTH/9802 /28/sudan.sleeping.sickness/__
Much has been reported about the gruesome deaths associated with hemorrhagic fevers, like Ebola, which can bring a quick death.
But imagine having your body slowly destroyed by a parasite that will literally drive you insane.
That death is what the bite of the tsetse fly can bring.
In the beginning, you may think you have the flu. You can run a high fever, have headaches, joint aches, even itching.
As the parasite spreads throughout your bloodstream, it takes its toll on your organs. You can develop anemia or endocrine disorders. You can develop heart and kidney problems. And pregnant women can lose their fetuses.
By the time the parasite reaches the central nervous system, you are vulnerable to unpredictable mood changes, and you are so weak that it wears you out to eat or even open your eyes.]
You are a danger to yourself and others because you can suffer from sudden bouts of aggressiveness. In some villages, the people tie sleeping-sickness victims to huts or poles to keep them from harming others.
Eventually wasted and destroyed, sleeping-sickness victims slip into a deep coma and die.
An old threat
Records indicate that Africans have fought against the sleeping sickness as far back as the 14th century.
In 1906, an outbreak of sleeping sickness killed 4 million people in Uganda.
Health officials say at that time, sleeping sickness was considered the No. 1 public health threat in the tropics.
Advantage Two: Global Health Diplomacy
China and US at odds for Oil control in Africa
William Engdahl, May 20, 2007
__http://www.engdahl.oilgeopoliti cs.net/print/China%20&%20US %20in%20Cold%20War%20over %20Africa's%20Oil.html__
The case of Darfur, a forbidding piece of sun-parched real estate in the southern part of Sudan, illustrates the new Cold War over oil, where the dramatic rise in China’s oil demand to fuel its booming growth has led Beijing to embark on an aggressive policy of – ironically – dollar diplomacy. With its more than $1.3 trillion in mainly US dollar reserves at the People`s Bank of China, Beijing is engaging in active petroleum geopolitics. Africa is a major focus, and in Africa, the central region between Sudan and Chad is priority. This is defining a major new front in what, since the US invasion of Iraq in 2003, is a new Cold War between Washington and Beijing over control of major oil sources. So far Beijing has played its cards a bit more cleverly than Washington. Darfur is a major battleground in this high-stakes contest for oil control.
In recent months, Beijing has embarked on a series of initiatives designed to secure long-term raw materials sources from one of the planet’s most endowed regions – the African subcontinent. No raw material has higher priority in Beijing at present than the securing of long term oil sources.
Today China draws an estimated 30% of its crude oil from Africa. That explains an extraordinary series of diplomatic initiatives which have left Washington furious. China is using no-strings-attached dollar credits to gain access to Africa’s vast raw material wealth, leaving Washington’s typical control game via the World Bank and IMF out in the cold. Who needs the painful medicine of the IMF when China gives easy terms and builds roads and schools to boot?
US being asked for more involvement and aid to Africa
New York Times ,Celia W. Dugger, Staff Writer 5/9/07
“Africa: Angola: U.S. Advised To Strengthen Ties To Stabilize Oil Supply
__http://query.nytimes.com/gst /fullpage.html?res=9E03E3DA1731 F93AA35756C0A9619C8B63&n=Top %2fReference%2fTimes%20Topics %2fSubjects%2fO%2fOil%20 %28Petroleum%29%20and%20Gasolin e__
A report sponsored by the Council on Foreign Relations, the nongovernmental, nonpartisan organization with headquarters in New York, said the United States should devote significant resources and diplomatic effort to developing ties with Angola, the second largest oil producer in sub-Saharan Africa after Nigeria, and strategically important for ensuring a steady supply of oil and the stability in the oil-rich Gulf of Guinea region. It noted that Angola had one of the world's fastest-growing economies but remained one of the world's least-developed countries. ''Cronyism and the labyrinthine bureaucracy that businesses must navigate to turn a profit frighten away all but the most courageous investors,'' the report said. CELIA W. DUGGER
China and US at zero sum game over resources in Africa
Drew Thompson, Assistant Director of the Freeman Chair in China Studies at the Center for Strategic and International Studies in Washington, DC, June 2005, “China’s Emerging Interests in Africa: Opportunities and Challenges for Africa and the United States”
__http://www.hollerafrica.com /showArticle.php?artId=156 &catId=1__
As China’s domestic economy grows, it is expanding and deepening political and economic relations in Africa, primarily to secure access to African markets and raw materials. There is rising concern among some in the United States that China’s growing influence in Africa is a zero-sum equation, whereby China’s rise will ultimately undermine U.S. interests in the region.
If china continues to rise it will go to war with the US
John Mearsheimer, prof of poli sci @ uchicago, Jan/Feb2005, CLASH OF THE TITANS, Foreign Policy, Issue 146, p46
China cannot rise peacefully, and if it continues its dramatic economic growth over the next few decades, the United States and China are likely to engage in an intense security competition with considerable potential for war. Most of China's neighbors, including India, Japan, Singapore, South Korea, Russia, and Vietnam, will likely join with the United States to contain China's power. To predict the future in Asia, one needs a theory that explains how rising powers are likely to act and how other states will react to them. My theory of international politics says that the mightiest states attempt to establish hegemony in their own region while making sure that no rival great power dominates another region. The ultimate goal of every great power is to maximize its share of world power and eventually dominate the system.
Contd…
From China's point of view, it would be ideal to dominate Asia, and for Brazil, Argentina, or Mexico to became a great power and force the United States to concentrate on its own region. The great advantage the United States has at the moment is that no state in the Western Hemisphere can threaten its survival or security interests. So the United States is free to roam the world causing trouble in other people's backyards. Other states, including China of course, have a vested interest in causing trouble in the United States' backyard to keep it focused there. The picture I have painted is not a pretty one. I wish I could tell a more optimistic story about the future, but international politics is a nasty and dangerous business. No amount of good will can ameliorate the intense security competition that will set in as an aspiring hegemon appears in Asia.
US-China war will cause a nuclear war ending civilization
The Straits Times 2K (Ching Cheong, June 25, “No one gains in war over Taiwan” ln)
THE high-intensity scenario postulates a cross-strait war escalating into a full-scale war between the US and China. If Washington were to conclude that splitting China would better serve its national interests, then a full-scale war becomes unavoidable. Conflict on such a scale would embroil other countries far and near and -horror of horrors -raise the possibility of a nuclear war. Beijing has already told the US and Japan privately that it considers any country providing bases and logistics support to any US forces attacking China as belligerent parties open to its retaliation. In the region, this means South Korea, Japan, the Philippines and, to a lesser extent, Singapore. If China were to retaliate, East Asia will be set on fire. And the conflagration may not end there as opportunistic powers elsewhere may try to overturn the existing world order. With the US distracted, Russia may seek to redefine Europe's political landscape. The balance of power in the Middle East may be similarly upset by the likes of Iraq. In south Asia, hostilities between India and Pakistan, each armed with its own nuclear arsenal, could enter a new and dangerous phase. Will a full-scale Sino-US war lead to a nuclear war? According to General Matthew Ridgeway, commander of the US Eighth Army, which fought against the Chinese in the Korean War, the US had at the time thought of using nuclear weapons against China to save the US from military defeat. In his book The Korean War, a personal account of the military and political aspects of the conflict and its implications on future US foreign policy, Gen Ridgeway said that US was confronted with two choices in Korea -truce or a broadened war, which could have led to the use of nuclear weapons. If the US had to resort to nuclear weaponry to defeat China long before the latter acquired a similar capability, there is little hope of winning a war against China 50 years later, short of using nuclear weapons. The US estimates that China possesses about 20 nuclear warheads that can destroy major American cities. Beijing also seems prepared to go for the nuclear option. A Chinese military officer disclosed recently that Beijing was considering a review of its "non first use" principle regarding nuclear weapons. Major-General Pan Zhangqiang, president of the military-funded Institute for Strategic Studies, told a gathering at the Woodrow Wilson International Centre for Scholars in Washington that although the government still abided by that principle, there were strong pressures from the military to drop it. He said military leaders considered the use of nuclear weapons mandatory if the country risked dismemberment as a result of foreign intervention. Gen Ridgeway said that should that come to pass, we would see the destruction of civilisation. There would be no victors in such a war. While the prospect of a nuclear Armaggedon over Taiwan might seem inconceivable, it cannot be ruled out entirely, for China puts sovereignty above everything else.
Advantage Three: Bioterrorism
The world is at a huge risk of bioterrorism
(Interpol, Bioterrorism, 18 July 2007, Interpol http://www.interpol.int/Public /BioTerrorism/default.asp) [APATRA]
Why is bioterrorism such a threat? The world is largely unaware of, and therefore largely unprepared for, bioterrorist attacks. Bio-weapons threaten thousands of casualties in addition to other disastrous long term consequences. Criminal networks can covertly transport lethal agents across borders and terrorists have already proven that anthrax can be fatally deployed.
Bio-technology is undergoing rapid evolution. This process, and the wide dissemination of developments, is already proving difficult to manage. There is evidence that terrorist organizations have a heightened interest in the use of biological weapons, establishing terrorist support cells in different regions around the world with the ability and motivation to carry out attacks.
An easy option? An effective biological weapon is potentially devastating and much easier to make and transport than a nuclear weapon. Bio-weapons are, however, relatively safe for the terrorist. Pathogens (biological agents or germs) are virtually undetectable and can be brought reasonably easily into a country by an individual and can then be propagated in large quantities.
Recognising the imminent dangers represented by this lethal form of crime is the first step in countering the threat. Thereafter it is vital to put in place the tools which will enable society to take appropriate measures.
Early response systems best warn against bioterrorism
Valerie Gregg, National Science Foundation Scientist, Spring 2002, Public Health http://www.whsc.emory.edu/ _pubs/ph/spring02/innocence .html [APATRA]
Bioterrorism requires a public health system that is strong and well coordinated at every level, Berkelman says. “Early detection by health care providers is our best early–warning system, and education of clinicians is an important defense. In turn, public health officials and health care providers must be tightly linked to assure early recognition and prompt response. Public health agencies and the health care system must, in turn, work seamlessly with other involved agencies, including law enforcement.”
Ensuring the strength of each link in the public health system is essential to controlling epidemics of any infectious disease, including those caused by bioterrorism. “The relationships are vital,” she says. “Surveillance for diseases caused by bioterrorism requires the same system as for other infectious disease. If we can make our public health departments stronger to prepare for bioterrorism, they will be better able to deal with other health threats like influenza, E. coli 0157, and meningococcal disease.”
Surveillance systems prevent bioterrorism by analyzing data
Chang M, Glynn MK, Groseclose SL. Endemic, notifiable bioterrorism-related diseases, United States, 1992-1999. Emerg Infect Dis [serial online] 2003 May http://www.cdc.gov/ncidod/EID /vol9no5/02-0477.htm [APATRA]
Using this guidance, public health systems can address the threat of bioterrorism by increasing healthcare sector awareness of and surveillance for these bioterrorism-related agents and the diseases they cause (__10__). In the United States, public health surveillance for conditions caused by the identified critical biologic agents is conducted in multiple ways. Although data regarding these agents are reported to different national surveillance systems at CDC, no single system is specifically designed for conducting surveillance for all bioterrorism-related agents or conditions. However, many states have routinely conducted surveillance for some of these conditions and report incidence data to CDC’s National Notifiable Diseases Surveillance System (NNDSS) each week (__Table 1__).
We describe disease-specific trends in demographic characteristics and geographic and seasonal distribution of selected conditions caused by critical biologic agents reported to NNDSS. These diseases and conditions include anthrax, botulism, brucellosis, cholera, plague, tularemia, and selected viral encephalitides. By identifying patterns of endemic disease associated with critical agents, we establish a baseline against which future disease incidence can be compared. This process should allow easier identification of unusual reports of disease incidence, which in turn will enhance the ability of the public health community to identify and investigate outbreaks.
Bioterrorism the most severe threat to extinction
Jason Matheny, Department of Agricultural and Resource Economics, University of Maryland, 10/7/06, (“Reducing the risk of human extinction”, http://www.acceleratingfuture .com/papers/extinction.htm)
Of current extinction risks, the most severe may be bioterrorism. The knowledge needed to synthesize a virus is modest compared to that needed to build a nuclear weapon; the necessary equipment and materials are increasingly accessible; and because biological agents are self-replicating, a single weapon can have an exponential effect on a population (Warrick, 2006). Current U.S. biodefense efforts are funded at $6 billion per year to develop and stockpile new vaccines and treatments, monitor biological agents and emerging diseases, and strengthen the capacities of local health systems to respond to pandemics.
Thus we offer the following plan:
THE UNITED STATES FEDERAL GOVERNMENT SHOULD SUBSTANTIALLY INCREASE ITS PUBLIC HEALTH ASSISTANCE TO SUB-SAHARAN AFRICA BY EXPANDING THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTER FOR DISEASE CONTROL AND PREVENTION’S GLOBAL DISEASE DETECTION PROGRAM TO 3 CENTERS TO BE LOCATED IN SUB-SAHARN AFRICA.
FUNDING AND ENFORCEMENT GUARANTEED THROUGH NORMAL MEANS.
WE RESERVE THE RIGHT TO CLARIFY
Observation Three: Solvency
A funding increase would strengthen the GDD to a point of useful aid
CDC Professional Judgment FY 2008 4/20/07
__http://www.fundcdc.org/document s/CDCFY2008PJ_000.pdf__ [KSutt]
CDC is a major partner in our nation’s frontline against emerging international health
threats. CDC’s Global Disease Detection program, in partnership with host country
governments and the WHO, is a key component of this effort and forms the foundation of a transnational detection, prevention and response network to address emerging health threats including pandemic influenza. With current funding levels, CDC has established 5 regional response Centers, but needs 18 – three in each WHO region - to complete the network and properly protect the nation. The existing Centers have already proven their effectiveness muand impact on detecting and responding to outbreaks including avian influenza, aflatoxin poisoning, Rift Valley fever, Ebola and Marburg virus outbreaks, and many other serious infectious diseases and environmental health threats. The Centers also provide a platform for regional training, surveillance, research, and health diplomacy activities that help promote sustainable health development in the targeted regions. CDC is a major global source of technical and scientific support to categorical disease control programs supported by USG, WHO, health ministries, PEPFAR, the Global Fund, and many other health organizations. Our investment is modest and highly leveraged, but our capacity in most critical areas has been eroded by budget attrition and increases in the costs of science, travel, and infrastructure support in the past few years. We need to continue and expand operational research to assure that investments the USG and others are making in international health are state-of-the science and optimized to achieve results in the field.
Surveillance and prediction through U.S. satellites is integral in developing countries to increase health worker effectiveness
NASA, Goddard Space Flight Center “Top Story” News, 2/5/02
“Satellites tracking climate changes and links to disease outbreaks in Africa”
__http://www.gsfc.nasa.gov /topstory/20020204riftvalley .html__ [KSutt]
Accurate prediction of epidemics is still years away. But in the short term, satellite monitoring could still benefit public health in developing countries where resources to combat disease are limited.
"It is not feasible to send health workers everywhere," Anyamba said. "But if we know where outbreaks are likely, those areas can be targeted. We can focus our efforts where they are needed."
Locating those areas requires the use of polar orbiting satellites, such as the Terra satellite, which NASA scientists use to monitor vegetation on the ground. Since green vegetation cover varies with rainfall, it is a good indicator of climate variability, and therefore of conditions necessary for disease outbreaks.
"So far, our team has mapped areas of Africa at risk for RVF outbreaks," Anyamba said. "Satellite mapping has identified where and when RVF outbreaks will occur."
CDC Surveillance is at the forefront of disease prevention and has worked in the past
Stephen Blount M.D., M.P.H., CDC Director of Global Health, 3/3/98
“Testimony on Global Health: the United States Response to Infectious Diseases”
__http://www.hhs.gov/asl/testify /t980303a.html__ [KSutt]
I'd also like to mention CDC's work in regard to surveillance and response to a few specific diseases, including influenza -- a disease that has recently been on our minds and in the news. Over the past year, CDC has augmented its international influenza network by increasing the number of surveillance sites in China from 6 to 12, and by training laboratorians from 14 countries in Latin America and the Caribbean. It has also provided resources for enhanced influenza surveillance in Russia. In addition, CDC has worked with the Pan American Health Organization to provide training in the diagnosis of influenza and dengue hemorrhagic fever to support active surveillance for these diseases in the Americas. CDC has played a major role in the development and distribution of reagents through the WHO network for diagnosis and surveillance of the new strain of influenza identified in Hong Kong. In conjunction with WHO, CDC has also provided leadership in the development of a protocol for enhanced surveillance for this new strain
Plan key to public health diplomacy
Benatar and Fox 05 – Professor of Medicine and Bioethics @ University of Cape Town and Professor of Sociology and Bioethics @ University of Pennsylvania [Solomon R. Benatar and Renée C. Fox, “Meeting Threats to Global Health: A call for American leadership,” Perspectives in Biology and Medicine 48.3 (2005) 344-361Project Muse]
Self-Interest as a Force for Improving Global Health - Just as America has sought widespread solidarity in its campaign against terrorism, so is it now in America's best interests to go beyond merely expressing concern about global health. It should set the example of providing solidarity with [End Page 356] others in their quest for access to the basic requirements for decent and healthy living that would give hope for their futures. In this sphere, self-interest and a globally responsive and responsible purview coincide. A glimmer that such thinking could increasingly impact on action is evident in the report from the U.S. Council of Foreign Relations and the Milbank Memorial Fund, outlining the importance of health to American foreign policy (Kassalow 2001). American economist Jeffrey Sach's work on the Commission on Macroeconomics for Health, the inauguration of a Global Health Fund, and President Bush's announcement that the United States will increase its annual development aid from $10 billion to $15 billion—while as yet only partially realized promises—are manifestations of both a deeper understanding of the importance of global health and an acknowledgement of the moral responsibility of developed nations to address this constructively (Friedman 2002; Global Fund 2002/3; WHO 2001). For the best American values—embracing both individual freedom and community responsibility—to become globally pervasive and sustainable, it will be necessary for the power of moral example and long-term national interest to complement economic and military power. Unless the world's most powerful country moves towards showing concern for the lives, health, and well-being of the underprivileged, both within its own borders and beyond, it is likely that the lives of the privileged in America and elsewhere will be progressively devalued by those who have little to lose (Nye 2002). The war on Iraq has severely damaged the reputation of the United States as a source of admired values and commitment to human well-being. It has also reduced the potential for the best of American values to be widely emulated (Soros 2004). The challenge of improving health for millions of people provides a window of opportunity to reclaim lost ground for the benefit of Americans and others. The vast gap between the 2004 U.S. military expenditure of $450 billion and official development assistance of only $15 billion illustrates the potential for innovative global health initiatives led by the United States (Sachs 2004). The Role of the American Medical Profession - In our view, it is both crucial and obligatory for the American medical profession to play a central role in the transformation of thought and action that would enable the United States to assume symbolic and substantive leadership in meeting present challenges to global health. As economist Jeffrey Sachs (2004) has stated: "For the first time in decades, we must strive to understand problems—tropical diseases, malnutrition, and the like—[that] are urgent concerns of people abroad. In the case of a superpower ignorance is not bliss; it is a threat to Americans and to humanity." The members of the American medical profession have the trained competence to understand these problems. What is more, as [End Page 357] physicians, they have a collective professional responsibility to be the "conscience of society" in matters that affect and are affected by health and illness. There are those both within and outside the U.S. medical profession who would respond to this exhortation with the claim that at this historical juncture, individually and collectively, American physicians do not have sufficient authority to assume the leadership role being asked of them—that they are too demoralized by the barrage of criticism for excessive dominance and autonomy to which they have been subject from the 1970s through the 1990s, and by their struggles to practice, under the current system of managed care, the kind of medicine that meets their standards of clinical and moral excellence. In response to this contention, we join with medical historian Rosemary Stevens in affirming that there are strong reasons to believe that if the profession mobilizes itself organizationally, its role as moral leaders could be effective: The profession has long had an authoritative voice in American culture. . . . Despite the doom and gloom expressed over managed care from the early 1990s to the present, doctors have not lost their normative role in American society. They embody a huge reservoir of goodwill inherited from the past. This is derived in various parts: from long respect of the doctor as healer; from the ideology of medicine as public service and the doctor as hero; from the huge advances of scientific medicine in the 20th century, continuing through promises to the future; from claims for scientific objectivity; from the symbolic value of medicine as culturally suited to other American values . . . and . . . from the sheer visibility of national medical organizations, even in the absence of a unified governmental health policy. (Stevens 2001, pp. 348–49)
The US must lead disease surveillance to ensure national security on bioweapons.
Amy Sands, Ph.D., Deputy Director, Center For Nonproliferation Studies, Monterey Institute Of International Studies, 3-19-02 (‘Reducing The Threat Of Chemical And Biological Weapons”, Hearing Before The Committee On Foreign Relations United States Senate One Hundred Seventh Congress, http://www.globalsecurity.org /military/library/congress /2002_hr/shrg319.pdf, p. 48 [KSutt]
To initiate such a process, the United States should work with Europe, Japan and other like-minded states to develop the national legislation needed to prevent misuse and unauthorized access to dangerous biological agents and toxins. Using these efforts as models, the U.S. must lead the effort on an international level and with industry and academia to define international standards of safety and security in the bio-technology sector so that we will have more control over where the materials of concern are, who has access to them, how they are controlled and how they are stored and transferred. A second recommendation is that we strengthen the public health sector within the United States and internationally. We need, obviously it’s been said already today, to improve our own public health sector, but we also need to work with other international groups and foreign governments to the same internationally. The proposed draft legislation of Senator Biden and Helms called the Global Disease Surveillance Act of 2002 reflects the fact that given the speed of international travel, migration patterns and commercial transportation networks, it will not be enough to shore up American public health capabilities and capacities, recognizing that the best BW delivery system might be humans either knowingly or not. Therefore we must assist others to develop capabilities for disease monitoring, surveillance and response or else leave ourselves vulnerable to the possible exposure to dangerous diseases that could be locally contained. Having recognized the need for more support in this area, the challenge, though, will now be to sustain these efforts both in the United States and elsewhere. Since these activities have dual benefits enhancing both national and international security and public health, it is hoped that their value will be clearly evident and funding will become an integral and ongoing element of our national and public security systems